Comparison
of Overactive Bladder Treatments Published in Mayo Clinic Proceedings

A study published in the April
Mayo Clinic Proceedings found that extended-release oxybutynin was more
effective than immediate-release tolterodine in treating overactive bladder,
a condition that is increasing as the population ages.

Comparison of
Overactive Bladder Treatments Published in Mayo Clinic Proceedings

ROCHESTER, MINN.
-- A study published in the April Mayo Clinic Proceedings found that extended-release
oxybutynin was more effective than immediate-release tolterodine in treating
overactive bladder, a condition that is increasing as the population ages.

The symptoms of overactive
bladder are urinary urge incontinence, urgency and frequency. More than
17 million people in the United States are affected, making it more prevalent
than asthma (15 million), osteoporosis (10 million), diabetes mellitus
(7 million) or Alzheimer's disease (4 million). The cost of treating overactive
bladder is considerable for patients, families and third-party payers.
In 1995, the estimated cost of urinary incontinence in patients older than
65 years was $26.3 billion.

"Even though overactive
bladder is not life threatening, it nonetheless decreases the quality of
life for many patients," write Daniel Elliott, M.D., Deborah Lightner,
M.D., and Michael Blute, M.D., of Mayo Clinic, in an accompanying editorial.
"The medical dollars spent on this problem are increasing. Therefore, it
is imperative for physicians to remain current on the latest advances in
this field and to prescribe wisely so that their patients receive the most
effective and cost-effective medication with the least adverse effects
for this troublesome medical condition."

The randomized, double-blind
trial was done by the Overactive Bladder Judging Effective Control and
Treatment (OBJECT) Study Group comprising 37 physicians. Rodney Appell,
M.D. of Baylor College of Medicine, Houston, Texas, is the first author
on the Proceedings article.

At 37 study centers
across the United States, 378 participants were randomized into two groups
to receive treatment with extended-release oxybutyinin or with tolterodine.
The study compared the tolerability and efficacy of the two drugs.

At the end of the
study, both drugs had improved symptoms of overactive bladder, but extended-release
oxybutynin was more effective than tolterodine in each of the main outcome
measures: weekly urge incontinence, total incontinence and urination frequency.
Both groups had similar rates of dry mouth, the most common adverse effect
of treatment with these drugs, and other adverse events.

The study was funded
by ALZA Corporation of Mountain View, Calif., the pharmaceutical company
that markets oxybutynin. The study's authors also disclosed their financial
ties to the company. The institutional review boards of each participating
study center approved the study, and each subject signed an institutional
review board-approved consent form.

Mayo Clinic Proceedings
is a peer-reviewed and indexed general internal medicine journal, published
for 75 years by Mayo Foundation, with a circulation of 130,000 nationally
and internationally.

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